Unidad de Medicina Nuclear, Hospital Universitario Virgen Macarena, Sevilla, Spain.
Unidad de Medicina Nuclear, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain.
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2024 Nov-Dec;43(6):500052. doi: 10.1016/j.remnie.2024.500052. Epub 2024 Sep 10.
To describe the therapeutic efficacy of radiosynoviorthesis with [Y]Yttrium citrate (Y), in patients with chronic knee synovitis refractory to systemic treatments and/or infiltrations, correlating the results with the different etiologies and degenerative changes that they showed, in order to optimize the indication of the technique.
Observational retrospective study with 32 patients (22 men and 10 women) and 34 knees, with refractory chronic knee synovitis, who underwent radiosynoviorthesis between January 2013 and December 2022. Its efficacy was described and analyzed by the subjective improvement referred by the patients and its relationship with the existing etiologies and radiological degenerative changes, expressed by the Kellgren-Lawrence (K-L) scale.
A statistically significant subjective improvement was observed in 70.6% of the cases (p < 0.001). There were 92.3% of cases with absent, doubtful or mild degenerative changes (K-L 0-2) who improved, while only 50% with moderate or severe changes (K-L 3-4) improved, showing statistically significant differences (p = 0.03). Among patients with chronic inflammatory origin of synovitis (spondyloarthropathies and rheumatoid arthritis), 80% improved, while in those with osteoarthritis (degenerative) origin, only 25% improved with statistically significant differences (p = 0.006).
Radiosynoviorthesis with Y is an effective treatment in patients with knee refractory chronic synovitis, especially in the presence of mil degenerative joint changes and chronic inflammatory origin. We must ensure the appropiate selection of patients according to these criteria.
描述放射性滑膜切除术联合柠檬酸[Y]钇（Y）治疗对慢性膝关节滑膜炎患者的疗效，这些患者对全身治疗和/或关节内注射治疗无效，将结果与不同病因和退行性改变相关联，以优化该技术的适应证。
这是一项回顾性观察研究，纳入了 2013 年 1 月至 2022 年 12 月期间接受放射性滑膜切除术的 32 名患者（22 名男性和 10 名女性）和 34 膝慢性膝关节滑膜炎患者。通过患者自述的主观改善情况来描述和分析其疗效，并与现有的病因和放射学退行性改变相关，退行性改变通过 Kellgren-Lawrence（K-L）分级来表示。
70.6%（p<0.001）的患者观察到有统计学意义的主观改善。92.3%（K-L 0-2）无、可疑或轻度退行性改变的患者得到改善，而只有 50%（K-L 3-4）中度或重度退行性改变的患者得到改善，差异具有统计学意义（p=0.03）。慢性炎症性滑膜炎（脊柱关节炎和类风湿关节炎）患者中，80%的患者得到改善，而退行性骨关节炎患者中，只有 25%的患者得到改善，差异具有统计学意义（p=0.006）。
Y 放射性滑膜切除术是治疗膝关节慢性滑膜炎患者的有效方法，尤其是在关节退行性改变较轻且病因是慢性炎症时。我们必须根据这些标准选择合适的患者。
